[Tumor mimicry].
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Biomedical subjects
Publications and source records attributed to I Vŭlkov.
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Explorative laparotomy with ensuing splenectomy in Hodgkin's disease is applied for the first time in the Stanford University in the late 60-ies. Opinions on the pros and cons of the method in terms of number of cases, complications and the like are largely dissenting. The analysis covers 153 patients with Hodgkin's disease subjected to splenectomy. Primary diagnosis is made on the ground of lymph node biopsy. Wide spreading of the disease, coincidence of diagnoses in different locations and complications are briefly discussed, with recommendations made concerning improvement of the organization of sample handling and correlation with the clinical findings.
The case of a 42 years old man suffering from Gaucher's disease is reported. The primary diagnosis was liver cirrhosis based on echographic and scintigraphic examinations. The following signs were found: thrombocytopenia, slight hemolysis, shortened life of the erythrocytes with considerable sequestration in the spleen, abnormal flocculation tests, increased acid phosphatase. The X-ray examination revealed irregularly oval light spots with different size and form and well cut outlines in the skull and a zone of bone resorption in the right shoulder joint. The liver needle biopsy showed parenchymal infiltration with Gaucher's cells. The above mentioned deviations and the family heredity of the patients suggested the diagnosis of an adult form of Gaucher's disease. The fibroplastic changes in the liver including formation of septa led to the suggestion of a link between Gaucher's disease and liver cirrhosis.
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The authors discuss the B-cellular lymphomas, producing various kinds of monoclonal paraproteins as well as parts of them--light or heavy chains. A case of a patient with lymphoplasmocytic malignant lymphoma, producing monoclonal IgM in pentamer form mainly, as well as in Valdenström disease but without the symptoms characteristic for it--hyperviscosity and hemorrhagic diathesis, is described. The disease has been histologically, cytologically and electron microscopically diagnosed. Attention is paid to the long-term relatively benign course and subsequent malignant course with manifested laboratory changes as well as change in the objective state, requiring the monotherapy to be substituted for active complex treatment, though the effect was unsatisfactory, with a fatal outcome of the inflammatory complications and progressive anemia. The place of the case in Kiel classification of malignant lymphomas is discussed.
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